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Recurrence patterns identify aggressive form of human papillomavirus-dependent vulvar cancer
McWhirter, RE and Otahal, P and Taylor-Thomson, D and Maypilama, EL and Rumbold, AR and Dickinson, JL and Thorn, JC and Boyle, JA and Condon, JR, Recurrence patterns identify aggressive form of human papillomavirus-dependent vulvar cancer, Australian and New Zealand Journal of Obstetrics and Gynaecology pp. 1-7. ISSN 0004-8666 (2019) [Refereed Article]
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© 2019 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists This is the peer reviewed version of the following article: McWhirter, R. E., Otahal, P. , Taylor‐Thomson, D. , Maypilama, E. L., Rumbold, A. R., Dickinson, J. L., Thorn, J. C., Boyle, J. A. and Condon, J. R. (2019), Recurrence patterns identify aggressive form of human papillomavirus‐dependent vulvar cancer. Aust N Z J Obstet Gynaecol., which has been published in final form at https://doi.org/10.1111/ajo.13075. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Aims: To assess whether women from the Arnhem Land cluster differ from women with vulvar squamous cell carcinoma (VSCC) and vulvar intraepithelial neoplasia (VIN) resident elsewhere in the NT in recurrence after treatment, disease progression and mortality.
Materials and Methods: A retrospective cohort study of NT-resident women diagnosed with VIN or invasive vulvar cancer (VSCC) between 1 January 1993 and 30 June 2015 was undertaken. Time to recurrence was assessed using cumulative incidence plots and Fine and Gray competing risk regression models. Mean cumulative count was used to estimate the burden of recurrent events.
Results: Indigenous women from Arnhem Land experienced more recurrences after treatment than non-Indigenous women, the cancers recurred faster, and Indigenous women have worse survival at five years.
Conclusion: In characterising the epidemiological features of this cluster, we have identified a particularly aggressive form of vulvar cancer. This provides a unique opportunity for elucidating the aetiopathological pathways driving vulvar cancer development that may ultimately lead to preventive and therapeutic targets for this neglected malignancy. Further, these findings have important implications for clinical practice and HPV vaccination policy in the affected population.
|Item Type:||Refereed Article|
|Keywords:||incidence, indigenous women, human papillomavirus, recurrence, vulvar cancer, vulvar intraepithelial neoplasia, vulvar neoplasms|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Oncology and carcinogenesis|
|Research Field:||Cancer diagnosis|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||McWhirter, RE (Dr Rebekah McWhirter)|
|UTAS Author:||Otahal, P (Mr Petr Otahal)|
|UTAS Author:||Dickinson, JL (Professor Joanne Dickinson)|
|Funding Support:||National Health and Medical Research Council (1060187)|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||13 View Download Statistics|
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